General Introduction:

PARASITOLOGY
Prepared by:
J.P. CAMINO
Medical Parasitology
deals with the parasites, which cause human infections
and the diseases they produce.

It is broadly divided into two parts:

1. Protozoology
2. Helminthology
PARASITES
are living organisms, which depend on a living host for their
nourishment, reproduction and survival. they multiply or undergo
development in the host.
CLASSIFICATION
• Ectoparasites inhabit only the
body surface of the host
without penetrating the tissue.

• Endoparasite is a parasite,
which lives within the body of
the host and is said to cause an
infection.
Endoparasites can further be classified as:
▪ Obligate parasite is a parasite which
cannot exist without a host.

▪ Facultative parasite is an organism

which may either live as parasitic
form or as free-living form.

▪ Accidental parasites: Parasites,

which infect an unusual host
 ▪ Aberrant parasites: Parasites,
which infect a host where they
cannot develop further.

• Free-living parasite: It refers to

nonparasitic stages of active
existence, which live independent of
the host.
HOST
an organism, which harbors the parasite and provides
nourishment and shelter to latter and is relatively larger than the
parasite.

The host may be of the following types:

▪DEFINITIVE HOST: The host, in which the adult
parasite lives and undergoes sexual reproduction.
▪ Intermediate host: The host, in
which the larval stage of the
parasite lives or asexual
multiplication takes place. In some
parasites, two different
intermediate hosts may be
required to complete different
larval stages. These are known as
first and second intermediate
hosts, respectively.

▪ Paratenic host: A host, in which

larval stage of the parasite remains
viable without further
development. Such host transmits
the infection to another host.
▪ Reservoir host: In an endemic area, a
parasitic infection is continuously kept
up by the presence of a host, which
harbors the parasite and acts as an
important source of infection to other
susceptible hosts.

▪ Accidental host: The host, in which

the parasite is not usually found, e.g.
man is an accidental host for cystic
echinococcosis.
 ZOONOSIS
-diseases and infections, which
are naturally transmitted
between vertebrate animals
and man (WHO, 1959).

-infectious disease that

has jumped from a non-
human animal to
humans.(WHO, 2020).
TYPES OF ZOONOSIS

▪Protozoal zoonoses, e.g.

Toxoplasmosis, leishmaniasis,
balanlidiasis and cryptosporidiosis.
TYPES OF ZOONOSIS
▪Fungal zoonoses. Some fungal
diseases, such as ringworm. Other fungal
diseases, like histoplasmosis, can't spread
from animals and people, but can infect
both animals and humans who are exposed
to fungi in the environment.
▪ Helminthic zoonoses,
e.g. Hydatid disease,
taeniasis.
▪Anthropozoonoses:
Infections transmitted to
man from lower
vertebrate animals,
 Zooanthroponoses:
Infections transmitted
from man to lower
vertebrate animals, e.g.
Human tuberculosis to
cattle.
 HOST-PARASITE RELATIONSHIPS

Host-parasite relationships
are of following types :
▪ Symbiosis
▪ Commensalism
▪ Parasitism
PARASITIC LIFE CYCLE
All parasites have a life cycle
that involves a period of time
spent in a host organism and
that can be divided into phases
of growth, reproduction, and
transmission. Life cycles of
parasites can be further divided
into two categories: direct
(monoxenous) and indirect
(heteroxenous)
LIFE CYCLE STAGES
1. Infective Stage at which the parasite is
able to initiate an infection to its host. The
stage that a parasite enters or invades and
continue developing within the host.

2. Diagnostic Stage at which the parasite

leaves the host, e.g. through excretion
together with the stool, urine, or sputum.
SOURCES OF INFECTION
Soil and water:
▪ Soil polluted with embryonated eggs
(roundworm, whipworm) may be
ingested or infected larvae in soil, may
penetrate exposed skin (hookworm).
▪ Infective forms of parasites present in
water may be ingested (cyst of amoeba
and giardia).
SOURCES OF INFECTION cont.
Food
▪ Ingestion of contaminated food or
vegetables containing infective stage
of parasite (amebic cysts,
toxoplasma oocysts, echinococcus
eggs).
▪ Ingestion of raw or undercooked
meat harboring infective larvae
(measly pork containing cysticercus
cellulosae, the larval stage of taenia
solium).
SOURCES OF INFECTION cont.
Vector: A vector is an agent,
usually an arthropod that transmits
an infection from man to man or
from other animals to man, e.g.
female anopheles is the vector of
malarial parasite.
Types of Vector
Biological Vector: refers to a
vector, which not only assists in
the transfer of parasites but the
parasites undergo development or
multiplication in their body as well.
They are also called as true
vectors.
E.g. Mosquitoes and ticks may carry
pathogens that can multiply within their
bodies and be delivered to new hosts,
usually by biting.
Types of Vector

Mechanical vectors:
The term mechanical vector
refers to a vector, which
assists in the transfer of
parasitic form between hosts
but is not essential in the life
cycle of the parasite.
E.g. Cockcroach and housefly
SOURCES OF INFECTION cont.

Carrier (Human Reservoir)

A person who is infected with parasite
without any clinical or subclinical
disease is known as carrier. For
example, all anthroponotic infections,
vertical transmission of congenital
infections.
SOURCES OF INFECTION cont.

Self (autoinfection):
The process of autoinfection
most frequently involves
the transfer of a life cycle
stage of the parasite from one
site to another inside the same
host, usually accompanied by
morphological transformation.
 MODES OF INFECTION

• Oral transmission: The most common method of

transmission is through oral route by contaminated
food, water, soiled fingers, or fomites.
• Skin transmission: Entry through skin is another
important mode of transmission. Hookworm
infection is acquired, when the larvae enter the skin
of persons walking barefooted on contaminated soil.
Schistosomiasis is acquired when the cercarial
larvae in water penetrate the skin.
• Vector transmission: Many parasitic diseases are
transmitted by insect bite, e.g. Malaria is
transmitted by bite of male anopheles mosquito,
filariasis is transmitted by bite of Culex mosquito.
• Direct transmission: Parasitic infection may be
transmitted by person-to-person contact in some
cases, e.g. by kissing in the case of gingival
amoebae and by sexual intercourse in
trichomoniasis.
• Vertical transmission: Mother to fetus
transmission may take place in malaria and
toxoplasmosis.
• Iatrogenic transmission: It is seen in case of
transfusion malaria and toxoplasmosis after
organ transplantation.
 PATHOGENESIS

• Parasitic infections may remain inapparent or give

rise to clinical disease. A few organisms, such as E.
histolytica may live as surface commensals,
without invading the tissue.
• Clinical infection produced by parasite may take
many forms: acute, subacute, chronic, latent, or
recurrent.
Pathogenic mechanisms, which can occur in parasitic
infections are:
Lytic necrosis: Enzymes produced by some parasite
can cause lytic necrosis. E. histolylica lyses intestinal
cells and produces amoebic ulcers.
TRAUMA: Attachment of hookworms on jejunal
mucosa leads to traumatic damage of villi and
bleeding at the site of attachment.
▪ Allergic manifestations: Clinical illness may be
caused by host immune response to parasitic
infection, e.g. Eosinophilic pneumonia in ascaris
infection and anaphylactic shock in rupture of
hydatid cyst.
▪ Physical obstruction: Masses of roundworm
cause intestinal obstruction. Plasmodium
falciparum malaria may produce blockage of
brain capillaries in cerebral malaria.
▪ Inflammatory reaction: Clinical illness may be caused
by inflammatory changes and consequent fibrosis, e.g.
Lymphadenitis in filariasis and urinary bladder
granuloma in Schistosoma haemalobium infection.
▪ Neoplasia: A few parasitic infection have been shown
to lead to malignancy. The liver fluke, Clonorchis may
induce bile duct carcinoma, and S. Haematobium may
cause urinary bladder cancer.
▪ Space occupying lesions: Some parasites produce
cystic lesion that may compress the surrounding
tissue or organ, e.g. hydatid cyst.
 IMMUNE EVASION

• All animal pathogens, including parasitic

protozoa and worms have evolved effective
mechanism to avoid elimination by the host
defense system
 LABORATORY DIAGNOSIS
• Most of the parasitic infection cannot be
conclusively diagnosed. On the basis of clinical
features and physical examination laboratory
diagnosis depends upon:
▪ Microscopy ▪ANIMAL INOCULATION
▪ Culture ▪XENODIAGNOSIS
▪ Serological test ▪ IMAGING
▪ Skin test ▪HEMATOLOGY
▪ molecular method
✓Microscopy
An appropriate clinical specimen should be collected for definitive diagnosis of
parasitic infections. Following specimens are usually examined to establish a
diagnosis:
• Stool
• Blood
• Urine
• Sputum
• Cerebrospinal fluid (CSF) Tissue and aspirates
• Genital specimens.